CN101500646A - External defibrillators for analysis of multiple arrhythmia conditions - Google Patents
External defibrillators for analysis of multiple arrhythmia conditions Download PDFInfo
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- CN101500646A CN101500646A CNA2007800301261A CN200780030126A CN101500646A CN 101500646 A CN101500646 A CN 101500646A CN A2007800301261 A CNA2007800301261 A CN A2007800301261A CN 200780030126 A CN200780030126 A CN 200780030126A CN 101500646 A CN101500646 A CN 101500646A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3904—External heart defibrillators [EHD]
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3925—Monitoring; Protecting
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Abstract
An external defibrillator and method are described that incorporate ECG rhythm analysis that can be used to advise a defibrillator shock based on the analysis. For certain conditions the analysis algorithm (70) may determine the heart to be in a rhythm that is not a candidate for unsynchronized defibrillation shock therapy (72), but is in a potentially serious condition that may be a candidate for cardioversion therapy (80) such as synchronized electrical cardioversion. If such a condition is detected by the analysis algorithm, the defibrillator prompts the user to consider cardioversion therapy (84), alerting clinicians to, and possibly accelerating application of, an alternative therapy that may be appropriate, without adding risks associated with automatic application of the therapy.
Description
The present invention relates to defibrillator, specifically, the present invention relates at threat to life and threat to life both of these case external defibrillator that patient's cardiac rhythm is analyzed not.
Defibrillator gives high-voltage pulse to heart, so that recover experiencing normal rhythm and contractile function such as the ARR patient of ventricular fibrillation (" VF ") (being also referred to as sudden cardiac arrest) or ventricular tachycardia (" VT ").There are some class defibrillators, comprise manual defibrillator, implanted defibrillator and automated external defibrillator (AED).The difference of AED and manual defibrillator is, AED is programmed in advance, analyze with automatic centering electrograph (" the ECG ") rhythm and pace of moving things, thereby determine that defibrillation is whether necessary and the measure of bestowing such as the shock sequences with suitable energy level is provided, be subsequently or succeeded by the time period of the patient being bestowed CPR.AED thereby be suitable for was not subjected to extensively, and the rescuer of medical training uses.Manual defibrillator is by support used by training and experienced clinician at advanced cardiac life, they can understand patient's ECG waveform, whether definite electric shock is suitable, defibrillator is set then to give correct shock sequences and energy level.
The purpose of AED is to allow to be subjected to the people of medical training seldom or allows not to be subjected to the people of medical training to save the defibrillation shock of life to the victim of sudden cardiac arrest (SCA) in some cases.Because research shows that it is normally very crucial to victim's existence to shock by electricity in initial a few minutes, it is very important allowing to dispose in the possible time before the rescuer who was subjected to training can reach the spot.Yet, because the unsuitable application of defibrillation shock may cause severe injury or death, especially because amateur rescuer lacks the result of senior medical training with error recovery, so AED conservatively is designed to highly be exclusively used in the situation that allows electric shock usually.
The target of defibrillation is, when the victim has ventricular fibrillation or non-perfusion tachycardia, stablizes unsuitable cardiac electrical activity by using electric shock, thereby recovers blood flow.Although most of AED algorithm is discerned ventricular fibrillation well, can not only determine according to the ECG signal whether tachycardia is perfusion property.The ventricular tachycardia of two-forty is considered to the fully full of ventricle provided the insufficient time, and the mechanism of VT produces the pump blood of poor efficiency.American Heart Association (American HeartAssociation) does not provide concrete recommendation to should when based on ECG tachycardia being shocked by electricity to dispose, and AHA indicates, will be understood that all tachycardias all originate from ventricle, unless can determine that the rhythm and pace of moving things originates from the chamber.Because the time between beating is too short for ventricular filling, therefore in addition supraventricular tachycardia (SVT) also can produce insufficient heart and export.
The AED algorithm that ventricular tachycardia is shocked by electricity has stricter standard usually to " organized " (simple form) tachycardia comparison highly irregular " amorphous " (pleomorphism) tachycardia that shows unanimity, repetition ECG.Some can maintain very high heart rate with the perfusion rhythm and pace of moving things, so, when the tachycardic rhythm and pace of moving things of pleomorphism keeps stablizing, this situation can be assumed to perfusion.Non-perfusion tachycardia can degenerate to the unsettled rhythm and pace of moving things usually, and it is recognized as usually and can shocks by electricity by parser.By electric shock simple form tachycardia is set very strict standard, reduced that dabbling patient is given unsuitable and has the chance of the electric shock of potential danger.
Yet some cardiologists have recommended a kind of more positive disposal method.These doctors advocate, even tachycardic type is suspicious, if tachycardia then has only very little chance to cause the non-perfusion rhythm and pace of moving things by electric shock for perfusion.And if applied electric shock causes the non-perfusion rhythm and pace of moving things, the vibration of the then modal rhythm and pace of moving things in recent dabbling heart, changing at an easy rate.Owing to the probability of the successful conversion of the non-perfusion rhythm and pace of moving things reduces along with the increase of dabbling length not, be desirably in and recover normal rhythm before reaching non-dabbling state.Causing under the situation of more serious situation, in hospital or EMS environment, sending the rescuer who was subjected to training.Therefore some cardiologists infer, the retardation ratio that the non-perfusion rhythm and pace of moving things is shocked by electricity shocks by electricity to the suspicious rhythm and pace of moving things and has higher risk.
In these cases, this thought, giving synchronous electric shock (AHA recommended at the tachycardic treatment of some classes) may be more suitable.Yet synchronously cardioversion is medical professional's the disposal of expection level that a kind ofly was subjected to the ACLS training, exceeds the unprofessional user of AED.Cardioversion can be synchronously, and often is a kind of contraindication for (asynchronous) defibrillation that is applied to respond the patient who is also breathing.Though defibrillation is to be used for the life-threatening situation of start up procedure scheme immediately, should start the disposal that utilizes synchronous cardioversion as early as possible according to reality usually.
Previous method has inquired into whether dispose the tachycardic uncertainty of simple form in a kind of mode in four kinds of modes:
1. highly special-purpose, to avoid the perfusion rhythm and pace of moving things is shocked by electricity by very high rate-valve value is set;
2. highly sensitive, so that disposal the earliest to be provided, this depends on the low-risk of the complication of unnecessary electric shock;
3. select the arbitrfary point with balance sensitivity and specificity; Perhaps
4. if suspect it is ventricular tachycardia, then automatically switch to synchronous cardioversion from defibrillation.
Every kind in these methods all has problem.Excessive special-purpose can the delay to treating from the electricity of the benefited situation of interventional therapy.When waiting the rhythm and pace of moving things that shocks by electricity to be determined, patient's situation may degenerate to recovers the point that probability reduces.Excessively sensitivity can cause unnecessarily and shocks by electricity, and this might cause the side effect that first respondent that was subjected to less training possibly can't handle.Middle defibrillation threshold value only exchanges another wrong risk with the risk of a mistake.For example at United States Patent (USP) 6,246, the automatic change of the pattern from (asynchronous) defibrillation to synchronous cardioversion described in 907 people such as () Lin has reduced the patient and used the relevant most of risk of asynchronous electric shock, but this does not reduce the probability of using unsuitable electric shock.In other words, the change of pattern does not change the probability of making the erroneous decision of using electric shock, if but given unsuitable electric shock, substitute asynchronous electric shock synchronously by switching to, reduced the chance that is converted to the non-perfusion rhythm and pace of moving things by the electric shock of application error.The disposal method that people such as Lin describe uses the start-up energy that is suitable for defibrillation, thereby, if can not obtain the QRS waveform so that the treatment impulsive synchronization in definite time frame then can be used asynchronous defibrillation therapy and substitute.Generally speaking, synchronously the energy threshold of cardioversion is well below the energy threshold of the rhythm and pace of moving things that needs defibrillation, and for monophasic shocks, and it is half of start-up energy of defibrillation that AHA recommends the start-up energy of synchronous cardioversion." 2005 Guidelines for CardiopulmonaryResuscitation and Cardiovascular Care " referring to American Heart Association.
If can postpone synchronous cardioversion, then do not want application of synchronized cardioversion immediately, this there are some other reasons.At first, the very pain that shocks by electricity can help the patient to relax misery and bestow anesthetis before.The second, the start-up energy level of cardioversion should be selected based on cardiac rhythm by experienced clinician, and, should before the application choice treatment, confirm defibrillator determining to the rhythm and pace of moving things.The 3rd, it often is different that preferred therapeutic electrode is placed atrial heart conversion and ventricular cardioversion.The 4th, the atrial fibrillation of expansion trends towards causing thrombosis, and, do not have preventative thrombolytic or be used for confirming not existing thrombotic echocardiographic cardioversion can remove blood clot and causing apoplexy.At last, select ECG to lead at the analysis that does not have leading QRS and can make defibrillator select wrong same beans-and bullets shooter, may trigger the electric shock of high T ripple that this can cause the definite situation that synchronous cardioversion is attempted to avoid.Most of disposal method comprises the AHA guide, indicates the rescuer who was subjected to the ACLS training and should confirm that before shocking by electricity it is same beans-and bullets shooter that defibrillator is correctly discerned QRS.
According to principle of the present invention, the warning that external defibrillator is used for alternate electrotherapy (such as cardioversion) by interpolation strengthens can be in response to the analysis of the rhythm and pace of moving things of peb treatment so that replenish the defibrillation scheme, and can't may use alternate electrotherapy automatically in the unsuitable environment.The inventive method strengthens the general electric shock decision parser based on ECG of external defibrillator, consider cardioversion under certain situation of including standard in as the disposal option to propose that the rescuer satisfies at the rhythm and pace of moving things of being analyzed, but cardioversion is not the candidate through confirming of defibrillation.Can this enhancing of augmentation, so that cardioversion can be applied to have the medical system that is given the user of cardioversion therapy by training by defibrillator, this cardioversion therapy or for utilizing the synchronous electric cardioversion of defibrillation device, perhaps alternately for inducing the Drug therapy of cardioversion.In the process that the rhythm and pace of moving things that is suitable for defibrillation is analyzed, defibrillator of the present invention can be used to indicate cardioversion therapy not indicating defibrillation and having appropriateness under the situation of suitable personnel and situation.Be not subjected to the personnel of fully training should by mistake not provide treatment, and can quicken treatment by the rescuer who was subjected to training from the prompting of equipment.The present invention has not overcome to the clinician and has warned defibrillator identified and available disposal concerns, and when not knowing that extra situation or needed other interventional therapys may this treatments of indication lag, automatic application of treatment.
In the accompanying drawings:
Fig. 1 is illustrating according to the defibrillator that can use of principle of the present invention under under the manual mode or automatic (AED) pattern;
Fig. 2 is the illustrating of defibrillation electrode that is used to be connected to the defibrillator of Fig. 1;
Fig. 3 is the illustrating of monitoring electrode that is used to be connected to the defibrillator of Fig. 1;
Fig. 4 is defibrillator the illustrating when the access door that is used for manual mode is shown in an open position of Fig. 1;
Fig. 5 is the simplified block diagram according to the defibrillator of Fig. 1 of the present invention;
Fig. 6 is the flow chart that illustrates according to the operational approach of external defibrillator of the present invention;
Fig. 7 A and Fig. 7 B adopt the defibrillator of Fig. 1 of graphic display device under the AED pattern and the diagrammatic sketch of the user interface under the manual mode according to principle of the present invention.
Fig. 1 is illustrating according to the external defibrillator 10 of principles of construction of the present invention.Defibrillator 10 has and is positioned on the shell 19, is shown as access door in the closed position (access door) 20.Being positioned on the end face of defibrillator 10 is the power-on button 22 that is labeled as " 1 ", and power-on button 22 powers on for defibrillator 10, and begins to point out first respondent 12 defibrillation electrode 16 to be connected to patient 14 process.Adjacent with power-on button 22 is the analysis button 24 that is labeled as " 2 ", and analysis button 24 starts the automatic analysis to the ECG signal of gathering from patient 24, and this is analyzed automatically and generates shock advised message.Can also start ECG after across the contact of defibrillation electrode 16 immediately automatically and analyze detecting the patient.Adjacent with analysis button 24 is the shock button 26 that is labeled as " 3 ", recommends to shock by electricity if ECG analyzes, and then shock button 26 starts giving across the patient's 14 of defibrillation electrode 16 defibrillation shock.Power-on button 22, analysis button 24 and shock button 26 collectives that are labeled as " 1 ", " 2 " and " 3 " are employed AED buttons 34 when operating defibrillator 10 under the AED pattern.Each button in the button 34 can also be operated under manual mode.As long as the logical order of AED user interface maintains to make to obscure and minimizes, not crucial just to the precise marking of AED button 34.
Being installed as the display 36 adjacent with AED button 34 is preferably and can shows such as the text of label and message and the liquid crystal display (LCD) of tracing the figure of line (trace) such as ECG.Being installed in printer 38 on the end face of defibrillator 10 is provided at and disposes the ECG signal collected during the patient and the hard copy printout output of event flag.One group soft key control 40 function selecting that provide according to softkey label display 36 on (shown in Figure 7) adjacent with display 36 are provided.Speaker 42 provides audio prompt to the user, especially when defibrillator 10 is in the AED pattern.Adapter 44 provides the coupling to other pick offs, and these pick offs are collected such as pulse oxygen saturation (SpO
2) patient parameter.
AED instruction label 46 is installed on the end face of defibrillator 10.AED instruction label 46 is to using first respondent of defibrillator 10 that enabled instruction is provided under its AED pattern.
Manual mode alarm tag 48 is installed on the top side of inserting door 20.Manual mode alarm tag 48 comprises and is designed to warn amateur first respondent not open text or the figure that inserts door 20.For example, if showing that the label of the text of " manual mode " has first respondent prevents the abundant implication obscured under emergency situations, then can use this text.The access of manual mode can further be protected by the mechanical key lock (not shown) on the access door 20 or by the software access code of the manual mode of realizing just entering by means of the combination of button press.
Fig. 2 is the illustrating of defibrillation electrode 16 with adapter 18, and this adapter 18 is used to insert the patient's adapter socket (not shown) on the defibrillator 10.Defibrillation electrode 16 be used to gather from patient's ECG signal and coupling from defibrillator 10 across patient's defibrillation shock the two.When defibrillator 10 is in the AED pattern, automatically selects defibrillation electrode 16, and when defibrillator 10 is set to operate, also can manually select defibrillation electrode 16 under manual mode.
Fig. 3 is the illustrating of one group of monitoring electrode 28 with adapter 30 of being used to be connected to the monitoring port 32 on the defibrillator 10.In order to illustrate, show three monitoring electrodes 28.Can leading at the ECG monitoring, five of leading such as realization three, ECG monitors or the various monitoring electrodes 28 that should be used for selecting more or less quantity of 12 lead ECG monitoring.
Fig. 4 has the illustrating according to defibrillator 10 of the present invention that is shown as the access door 20 that is shown in an open position.Manually insert the access of button 50 control manual modes.Under manual mode, can utilize manual function to select control 51 to select to comprise the various manual functions of defibrillation, synchronous cardioversion or pace-making.Be installed on the bottom side of inserting door 20 is the manual mode instruction label 52 that instruction is provided to the ACLS user who carries out operate in manual mode.Only when access door 20 was shown in an open position, it was just visual to the user manually to insert button 50, manual function selection control 51 and manual mode instruction label 52.
In alternate embodiment of the present invention, can insert door 20 switchings of finishing between AED pattern and the manual mode by opening simply, push manual access button 50 defibrillator 10 is placed the needs of manual mode thereby eliminated.Switch or pick off (not shown) can be coupled to access door 20, defibrillator 10 be placed the open position or the closed position of the access door 20 of manual mode or AED pattern respectively with sensing.When defibrillator 10 was in manual mode, the manual function below access door 20 selected 51 still to be used for selecting between various manual functions.
Fig. 5 is the simplified block diagram according to defibrillator 10 of the present invention.ECG front end 100 is connected to defibrillation electrode 16, and defibrillation electrode 16 is connected with it successively across patient's chest.ECG front end 100 can be used for the electric ECG signal that heart generated to the patient and amplifies, cushions, filters and with its digitized, to generate the ECG sample of string numberization.But digitized ECG sample is offered the controller 102 of execution ECG analysis to detect VF, VT or other shockable rhythm.But if detect shockable rhythm, controller 102 just gives 104 to HV and sends signals, to charge so that prepare for giving defibrillation shock.Then, can trigger HV via controller 102 to pushing of shock button 26 (shown in Fig. 1) and give 104, to give defibrillation shock by 16 couples of patients of electrode.
What be connected to ECG front end 100 equally is one group of monitoring electrode 28.ECG front end 100 can be selected between defibrillation electrode 16 and monitoring electrode 28, preferably selects under the control of controller 102.
Memorizer 106 can be implemented as plate and carries RAM or ROM, mobile memory card, the combination of perhaps different memory technologies.Memorizer 106 comprises AED personality program 108 and manual personality program 110.108 operations of definition defibrillator 10 under the AED pattern of AED personality program are such as the operation to information content shown on AED button 34 and the display 36.Manual personality program 110 operations of definition defibrillator 10 under manual mode are such as the operation of button 34, soft key control 40, manual function being selected information content shown on control 51 and the display 36.
Fig. 6 is the flow chart according to the operating sequence of defibrillator 10 of the present invention.When controller 102 began to accept ECG sample from ECG front end 100, whether controller began to carry out its ECG analysis routines 70, but so that exist in 72 decision shockable rhythm.When the ECG analysis routines indicates the tachycardic life-threatening arrhythmia of existence such as VF or pleomorphism, notify the user to advise shocking by electricity 74.The message of " suggestion is shocked by electricity " can be sent by speaker 42 with listening, and also can or alternately show on display 36.When shocking by electricity, this message is other message such as the warning of not touching the patient that the user is sent subsequently.Then, 76, the capacitor that HV gives 104 pairs of high-tension circuits charges and shocks by electricity, and is preferably biphasic defibrillation pulse.
Alternately, 72, the ECG analysis routines may infer that life-threatening arrhythmia does not exist.According to the present invention, 80, whether ECG analysis routines assessment ECG data are suitable to determine cardioversion.Illustrated among the embodiment of explanation, if the ECG analysis routines is confirmed as suitably defibrillation synchronously or chemical cardioversion may analyze by suitable heart condition.For example, the ventricular tachycardia that per minute surpasses 150 heart beatings may not satisfy all indications to defibrillation shock of AED algorithm, if but thought fit by the supplier of ACLS training, AHA just allows to utilize synchronized cardioversion that this rhythm and pace of moving things is disposed.When the result of this analysis is not identified as suitably for there being other treatment, then send the message of " not advising shocking by electricity ", and 70, defibrillator continues ECG is analyzed 82.When the result of this analysis suitably the time, considers cardioversion 84 suggestion users for cardioversion.This can finish by the visual display and/or the sound generative capacity of equipment, to notify the clinician alternative disposal to proposing in response to the cardiac rhythm of cardioversion therapy.For example, ECG analyze determine do not indicate defibrillation but this analysis is determined synchronously or chemical cardioversion may be suitably after, defibrillator shows word " consideration cardioversion " on display 36, and announcement on speaker 42 " is not advised carrying out defibrillation, considered cardioversion." auditory tone cues.Vision and can listen the two accurate wording to determine by user's needs, and can be translated as the language in the place that is suitable for using defibrillator.If visual displays or audio tweeter are not the part of defibrillator, then omit corresponding announcement.Can use other forms of announcement, such as tone, light or other non-speech warning or speech warning.Then, 70, defibrillator restarts ECG to be analyzed, unless the qualified operator of ACLS brings into use defibrillator to use replacement therapy as described below.
Fig. 7 A and 7B are respectively defibrillator 10 under the AED pattern and the illustrating of the part of the user interface under manual mode.In Fig. 7 A, defibrillator 10 is in the AED pattern, and the AED button 34 that is used to operate defibrillator 10 is by one group on the display soft label 54 labellings, and soft label 54 comprises " opening ", " analysis " and " electric shock ", and it is according to AED individual character 108 its functions of definition.The graphical trace 56 of ECG signal can show at the core of display 36.Comprise message blocks 58 such as the selected user prompt of " do not advise shocking by electricity, check patient " can place display 36 than on the lower part.In this example, defibrillator is only inferred its analysis to the desirable property of replacement therapy, and infers that cardioversion may be suitable to the patient, in this case, and message blocks 58 suggestion users' " consideration cardioversion ".Soft key control 40 can be configured to utilize defibrillator 10 to open or close according to the particular version of the AED personality program of having selected 108.In some EMS systems, can not realize soft key control 40, yet in other EMS systems, when defibrillator is in the AED pattern, can obtain one group of selected function.
In Fig. 7 B, can push by opening and insert the door 20 manual access buttons 50 that show, so that defibrillator 10 is placed manual mode.Under manual mode, this organizes soft label 54 along with the menu structure that the controllable function of more high-grade ACLS user is added to according to the manual mode of manual personality program 110 changes.As shown in the figure, this on the display organized soft label 54 and shown " energy selection ", " charging " and " electric shock " now, and it has defined the function of button 34 when operating defibrillator under manual mode.Various manual functions such as synchronous cardioversion or pace-making can select 51 to select with being positioned at the manual function that inserts door 20 belows equally.In addition, can activate soft key control 40 represents and for example comprises " report to the police and be provided with ", " selection of leading " and " SpO
2" one group of soft label 60, add soft label 60 with each the function in the labelling soft key control 40, soft key control 40 is used for the additional customer's control according to the manual function of manual personality program 110.Can realize menu tree and it is logically arranged, thereby provide ready access according to manual personality program 110 available expectation manual functions.
In the non-critical wards of hospital environment, be subjected to highly the clinician of training to arrive the scene of cardiac event usually in the time of approximately the patient having been used AED and the rhythm and pace of moving things is being analyzed.Because the nurse of first response may not support to be subjected to abundant training aspect the technical ability at advanced cardiac life, many hospitals use the advanced defibrillator under the AED pattern in these non-critical zones.So the AED pattern is provided at the required initial rescue of this early stage response duration immediately.Can show consideration to the qualified rescuer of ACLS of follow-up with the prompting of cardioversion, and the rescuer that the ACLS of follow-up is qualified can respond correspondingly as the disposal option.Alternately, can strengthen the more AED of foundation level, so that randomly give synchronous cardioversion by those people that were subjected to suitable training.In another embodiment, algorithm can be advised that cardioversion is used as the extra monitoring warning of heart monitor, but be independent of analysis shockable rhythm.
For advanced defibrillator, can realize that it is relevant with equipment to the application of the replacement therapy of the application of known of synchronous cardioversion pulses.A this defibrillator enters manual mode with this realization by the AED pattern that withdraws from operation.Press knob with starting " synchronized cardioversion mode ", the suitable energy of strobe pulse, and press " charging " button.Behind equipment charge, press " electric shock " button to give the cardioversion electric shock.The clinician is responsible for determining whether the patient performs the preparation of electric cardioversion, for example, and sedated/unconscious; If recommend then carry out thrombolytic, and definite ECG indication is suitable to treatment.
As another example, advanced defibrillator is application of synchronized cardioversion under the AED pattern more simply, such as by pressing the button with starting " synchronized cardioversion mode " but do not withdraw from AED and use.Make defibrillator automatically charge to predetermined cardioversion level by using by the pulse of pressing the triggering of " electric shock " button.The scheme of alternative method can determine that this depends on staff's training level by the clinical service of disposing defibrillator.Defibrillator can be configured to and is used for different therapeutic schemes.
For the AED on basis, it is normally desirable that the people who prevents those ACLS that was not subjected to be used for the treatment of trainings is used for cardioversion with the AED on basis.For example, only the operator with after only the known mode of user that was subjected to training being pressed button on the defibrillator, perhaps can just can implement the application of synchronous cardioversion with the code of the higher level operation of some additive methods realization defibrillators by keying in.The restriction of cardioversion mode use prevented that unprofessional user from bestowing only should be by the treatment of the expert's execution that was subjected to suitable training.
Claims (18)
1, a kind of external defibrillator comprises:
Pair of electrodes, it can be used for giving defibrillation shock and receives the ECG signal;
Controller, in response to described ECG signal, described controller is used for described ECG signal is analyzed determining whether that suggestion carries out defibrillation shock,
Wherein, do not advise carrying out defibrillation shock if analyze to determine, then described controller is further in response to described ECG signal, to determine whether considering alternate heart electrotherapy; And
User interface, in response to considering the definite of alternate heart electrotherapy, described user interface can be used for providing the user message that should consider alternate heart electrotherapy.
2, external defibrillator as claimed in claim 1, wherein, described alternate heart electrotherapy comprises cardioversion.
3, external defibrillator as claimed in claim 2, wherein, described user interface comprises the display that can be used for showing the message that should consider cardioversion.
4, external defibrillator as claimed in claim 2, wherein, described user interface comprises the speaker that can be used for sending the audible messages that should consider cardioversion.
5, external defibrillator as claimed in claim 1 comprises that also high pressure gives circuit, and it is in response to described controller and be coupled to described electrode, and described high pressure gives circuit and is used in and gives defibrillation shock when defibrillation shock is carried out in suggestion.
6, external defibrillator as claimed in claim 5, wherein, described high pressure gives circuit and also is used in and gives cardioversion therapy after the described user message that should consider alternate cardiac treatment is provided.
7, external defibrillator as claimed in claim 6, wherein, described external defibrillator plans to use for the qualified rescuer of non-ACLS,
Wherein, described external defibrillator is configured to have only the qualified rescuer of ACLS can give cardioversion therapy.
8, external defibrillator as claimed in claim 7, wherein, described external defibrillator can be used under the AED pattern by the qualified rescuer of non-ACLS, and can be used under manual mode by the qualified rescuer of ACLS.
9, external defibrillator as claimed in claim 1 wherein, is programmed to described controller, and defibrillation shock is carried out in suggestion when having ventricular fibrillation or pleomorphism tachycardia to indicate in the analysis to described ECG signal; And
Wherein, further described controller is programmed, cardioversion is considered in suggestion when existing simple form tachycardic to indicate in the analysis to described ECG signal.
10, a kind of method of operating body external defibrillator comprises:
Object is used electrode;
Receive the ECG signal;
Described ECG signal is analyzed, carried out defibrillation shock to determine whether suggestion;
When not advising carrying out defibrillation shock, analyze described ECG signal, to determine whether to consider alternate heart electrotherapy; And
Notify described user to consider alternate heart electrotherapy.
11, method as claimed in claim 11 wherein, notifies described user to comprise that also the described user of suggestion considers cardioversion.
12, method as claimed in claim 11 also is included in after the described user of suggestion considers cardioversion, analyzes described ECG signal by the qualified rescuer of ACLS; And
Can advise cardioversion if the rescuer that described ACLS is qualified determines, then give synchronous cardioversion therapy by the qualified rescuer of described ACLS.
13, method as claimed in claim 10 also comprises if suggestion is determined in the analysis of described ECG signal and carries out defibrillation shock, then gives asynchronous defibrillation shock.
14, method as claimed in claim 10 wherein, is notified described user also to comprise and is notified the qualified rescuer of non-ACLS should consider alternate cardiac treatment; And
Also comprise and prevent that the qualified rescuer of described non-ACLS from utilizing described external defibrillator to use described alternate cardiac treatment.
15, method as claimed in claim 14 also comprises allowing the qualified rescuer of ACLS to utilize described external defibrillator to use described alternate cardiac treatment.
16, method as claimed in claim 15 wherein, describedly allows also to comprise identification user input, and then to discern described rescuer be the qualified rescuer of ACLS.
17, method as claimed in claim 15, wherein, described external defibrillator can be used under the AED pattern or under the manual mode;
Wherein, when described defibrillator is operated, carry out the step before the qualified rescuer of permission ACLS uses described alternate cardiac treatment under described AED pattern; And
Wherein, when described defibrillator is operated, carry out allowing the qualified rescuer of ACLS to utilize described external defibrillator to use the described step of described alternate cardiac treatment under described manual mode.
18, method as claimed in claim 10 also comprises:
Indicate when having ventricular fibrillation or pleomorphism tachycardia in analysis, determine suggestion and carry out defibrillation shock described ECG signal; And
Wherein, indicate when having the simple form tachycardia, finish and notify described user to consider alternate cardiac treatment in analysis to described ECG signal.
19, a kind of external defibrillator comprises:
Pair of electrodes, it can be used for giving defibrillation shock and receives the ECG signal;
Controller, in response to described ECG signal, described controller is used for described ECG signal is analyzed determining whether that suggestion carries out defibrillation shock,
Wherein, do not advise carrying out defibrillation shock if analyze to determine, then described controller is then further in response to described ECG signal, to determine whether considering cardioversion; And
User interface, in response to considering the definite of cardioversion, described user interface can be used for providing the user message that should consider cardioversion.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US82258806P | 2006-08-16 | 2006-08-16 | |
| US60/822,588 | 2006-08-16 |
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| CN101500646A true CN101500646A (en) | 2009-08-05 |
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| CNA2007800301261A Pending CN101500646A (en) | 2006-08-16 | 2007-08-08 | External defibrillators for analysis of multiple arrhythmia conditions |
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| JP (1) | JP2010500144A (en) |
| CN (1) | CN101500646A (en) |
| WO (1) | WO2008020369A1 (en) |
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| WO2015051619A1 (en) * | 2013-10-10 | 2015-04-16 | 深圳迈瑞生物医疗电子股份有限公司 | Arrhythmia detection device |
| CN106938121A (en) * | 2016-01-05 | 2017-07-11 | 陈生泰 | External defibrillation pacing system |
| CN107106857A (en) * | 2014-12-18 | 2017-08-29 | 皇家飞利浦有限公司 | For wearable cardioverter-defibrillator (WCD) apparatus and method of the wearing of improved comfortableness and longer time |
| CN107249683A (en) * | 2014-12-12 | 2017-10-13 | 皇家飞利浦有限公司 | Utilize the automated external defibrillator (AED) of double ECG parsers |
| CN108135522A (en) * | 2016-01-16 | 2018-06-08 | Zoll医疗公司 | In ECG data can shockable rhythm or can not shockable rhythm quick identification |
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| US9067055B2 (en) * | 2009-09-28 | 2015-06-30 | Koninklijke Philips N.V. | Defibrillator with pre-connected electrode pads with reduced susceptibility to false asystole indications |
| CN102665819B (en) | 2009-11-30 | 2016-06-15 | Zoll医疗公司 | The display of dual-mode medical device |
| MX348854B (en) * | 2013-03-12 | 2017-07-03 | Koninklijke Philips Nv | Defibrillator and method using limb leads for artifact free ecg. |
| JP6502927B2 (en) * | 2013-06-11 | 2019-04-17 | コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． | Automatic defibrillation operation for a defibrillator |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE69829358T2 (en) * | 1997-11-06 | 2006-04-06 | Koninklijke Philips Electronics N.V. | EXTERNAL DEFIBRILLATOR WITH CPR INDICATIONS AND WITH ACLS INDICATIONS |
| US20040138713A1 (en) * | 2002-11-13 | 2004-07-15 | Stickney Ronald E. | External defibrillation and transcutaneous pacing device and methods for operating the device |
-
2007
- 2007-08-08 CN CNA2007800301261A patent/CN101500646A/en active Pending
- 2007-08-08 JP JP2009524271A patent/JP2010500144A/en active Pending
- 2007-08-08 WO PCT/IB2007/053144 patent/WO2008020369A1/en active Application Filing
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| WO2015051619A1 (en) * | 2013-10-10 | 2015-04-16 | 深圳迈瑞生物医疗电子股份有限公司 | Arrhythmia detection device |
| CN104546010A (en) * | 2013-10-10 | 2015-04-29 | 深圳迈瑞生物医疗电子股份有限公司 | Arrhythmia detection device |
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2008020369A1 (en) | 2008-02-21 |
| JP2010500144A (en) | 2010-01-07 |
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